Airway Microbiome in Asthma: Relationships to Asthma Phenotype and Inhaled Corticosteroid Treatment
There are new, very sensitive methods for detecting bacteria. These methods show that hundreds of millions of microbes (organisms that can only be seen with microscopes), especially bacteria, live in healthy people. The collection of different microbes found in a site is called a "microbiome." The investigators know that microbiomes of the skin, sinuses, mouth, gastro-intestinal tract, etc. differ from each other. The make-up of the microbiome - which bacteria are found in a site - may be necessary for good health. For example, the microbiome of the mouth is different in people with inflammation of the gums (periodontitis), and the microbiome of the bowel is different in people with inflammation of the intestinal tract (inflammatory bowel disease).
The purpose of this research study is to find out if the microbiome in the lungs is different in healthy people without asthma compared to people with asthma. This study will also find out if the microbiome of the lungs changes when people with asthma take a daily "controller" medication called an inhaled corticosteroid.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
-
-
California
-
San Francisco, California, Vereinigte Staaten, 94143-0130
- University of California, San Francisco, Adult
-
-
Colorado
-
Denver, Colorado, Vereinigte Staaten, 80206
- National Jewish Health
-
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Illinois
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Chicago, Illinois, Vereinigte Staaten, 60611
- Northwestern Memorial Hospital
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Massachusetts
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Boston, Massachusetts, Vereinigte Staaten, 02115
- Brigham & Women's Hospital
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-
Missouri
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St. Louis, Missouri, Vereinigte Staaten, 63110
- Washington University
-
-
North Carolina
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Durham, North Carolina, Vereinigte Staaten, 27110
- Duke University School of Medicine
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Winston-Salem, North Carolina, Vereinigte Staaten, 27157
- Wake Forest University Health Sciences
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Pennsylvania
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Pittsburgh, Pennsylvania, Vereinigte Staaten, 15213
- University of Pittsburgh, Adult
-
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Wisconsin
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Madison, Wisconsin, Vereinigte Staaten, 53972
- University of Wisconsin
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
Asthmatic:
- History of physician-diagnosed asthma.
- Methacholine PC20 < 8mg/ml and/or FEV1 improvement ≥ 12% in response to 180 mcg albuterol.
- FEV1 ≥ 70% of predicted after 180 mcg albuterol.
- Stable asthma for ≥ 3 months prior to enrollment (no urgent care visits, no systemic corticosteroid treatment).
- Asthma Control Questionnaire 6 Score < 1.5.
- Able to provide informed consent.
- Able to perform spirometry as per ATS criteria.
- Evidence by allergen skin test of sensitivity to an aeroallergen.
- Willingness, if female and able to conceive, to utilize one medically-acceptable form of contraception.
Healthy Control:
- Evidence by allergen skin test of sensitivity to an aeroallergen.
- Able to provide informed consent.
- Able to perform spirometry as per ATS criteria.
Exclusion Criteria:
Asthmatic:
- Presence of lung disease other than asthma.
- Use of > 10 doses of nasal corticosteroids in the previous 3 months.
- Presence of significant medical illness or other chronic diseases whose treatment could affect the clinical features measured, responses to the therapies to be given in this study, or risks of participating in the study.
- History of atrial or ventricular tachyarrhythmia.
- Changes suggestive of cardiac ischemia on ECG at baseline.
- History of upper respiratory infection, sinusitis, bronchitis, or antibiotic use in the previous 3 months.
- History of chronic sinus disease.
- Smoking > 5 pack-years, or within the past year
- History of long-term controller medication use for asthma (inhaled or oral corticosteroid, leukotriene pathway antagonist, cromolyn, or theophylline within the preceding 6 months.
- History of bleeding disorder.
- Reduced creatinine clearance.
- Inability, in the opinion of the Study Investigator, to coordinate use of inhaler or otherwise comply with medication regimens.
- Contraindication to bronchoscopy on history or examination.
Healthy Control:
- History of chronic respiratory disease including asthma.
- Presence of significant medical illness or other chronic diseases whose treatment could affect the clinical features measured, responses to the therapies to be given in this study, or risks of participating in the study.
- History of atrial or ventricular tachyarrhythmia.
- Changes suggestive of cardiac ischemia on ECG at baseline.
- History of upper respiratory infection, sinusitis, bronchitis, or antibiotic use in the previous 3 months.
- Methacholine PC20 < 16 mg/ml or FEV1 improvement ≥ 12% in response to albuterol.
- History of chronic sinus disease
- Smoking > 5 pack-years, or within the past year
- Use of > 10 doses of a nasal corticosteroid preparation in the previous 3 months
- FEV1 or FVC < 80% predicted.
- History of bleeding disorder.
- Reduced creatinine clearance.
- Contraindication to bronchoscopy on history or examination.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Vervierfachen
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Kein Eingriff: Gesunde Kontrolle
|
|
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Experimental: Inhaled corticosteroid
Fluticasone (250 mcg/puff, one puff, twice a day)
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Dry Powder Inhaler: 250 mcg/puff, one puff, twice a day
Andere Namen:
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|
Placebo-Komparator: Placebo
Placebo fluticasone (one puff, twice a day)
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Dry Powder Inhaler: Placebo
|
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Kein Eingriff: Atopic Non-asthmatics
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Microbial Community Richness
Zeitfenster: baseline and after 6 weeks of treatment
|
Richness is the total number of different bacterial taxa detected in the sample.
|
baseline and after 6 weeks of treatment
|
|
Microbial Community Diversity
Zeitfenster: baseline and after 6 weeks of treatment
|
The Shannon diversity index is a type of entropy measure and is a function of the distribution of the total number of organisms across all of the species.
If S is the total number of species in the sample and p_i is the number of organisms in the i-th species divided by the total number of organisms, then Diversity = -Σ p_i log(p_i).
|
baseline and after 6 weeks of treatment
|
|
Microbial Community Evenness
Zeitfenster: baseline and after 6 weeks of treatment
|
Pielou's evenness index is a scaled measure of biodiversity and is equal to the observed Shannon diversity index divided by the maximum possible Shannon diversity index, which would occur if all of the species in the sample were equally abundant.
Evenness = D/log(S), where D is the Shannon Diversity index and log(S) is the maximum diversity of the sample.
|
baseline and after 6 weeks of treatment
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Lewis Smith, MD, Northwestern Memorial Hospital
- Hauptermittler: Richard Martin, MD, National Jewish Health
- Hauptermittler: Christine Sorkness, MD, University of Wisconsin, Madison
- Hauptermittler: Sally Wenzel, MD, University of Pittsburgh Medical Center
- Hauptermittler: Stephen Peters, MD, Wake Forest University Health Sciences
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen der Atemwege
- Erkrankungen des Immunsystems
- Lungenkrankheit
- Überempfindlichkeit, sofort
- Bronchialerkrankungen
- Lungenerkrankungen, obstruktive
- Überempfindlichkeit der Atemwege
- Überempfindlichkeit
- Asthma
- Physiologische Wirkungen von Arzneimitteln
- Autonome Agenten
- Agenten des peripheren Nervensystems
- Entzündungshemmende Mittel
- Dermatologische Wirkstoffe
- Bronchodilatatoren
- Anti-Asthmatiker
- Atemwegsmittel
- Antiallergische Mittel
- Fluticason
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- AsthmaNet 003
- U10HL098115 (US NIH Stipendium/Vertrag)
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